Retrospective analysis of application of structured triglyceride after pancreaticoduodenectomy

Objective To investigate the application of structured triglyceride (STG) in malignant obstructive jaundice (MOJ) patients after pancreaticoduodenectomy. Methods The records of 21 MOJ patients received pancreaticoduodenectomy in our hospital were retrospectively analyzed. The patients received parenteral nutrition on the first postoperative day, of whom 7 were given STG (STG group) and 14 were given medium and long chain triglyceride (MCT/LCT group). The changes of liver function, lipid profile, albumin, and postoperative complications were compared between the two groups. Results The triglyceride levels in the STG group on the 3rd and 7th postoperative days were significantly lower than those in the MCT/LCT group [3rd day: (1.85±0.90)mmol/L vs. (2.18±1.41)mmol/L; 7th day: (1.62±0.78)mmol/L vs. (2.46±1.62)mmol/L; both P=0.042]; the level of high-density lipoprotein on the 7th postoperative day was significantly higher than that in the MCT/LCT group [(0.67±0.64)mmol/L vs. (0.45±0.15)mmol/L, P=0.046]. The albumin in the STG group returned to normal on the 3rd postoperative day, which was significantly higher than that in the MCT/LCT group [(35.50±2.91)g/L vs. (30.66±5.08)g/L, P=0.048]. There were no significant differences in terms of liver function, length of hospital stay, wound healing, systemic inflammatory response syndrome, and infection between the two groups. Conclusions Parenteral nutrition with structured triglyceride after pancreaticoduodenectomy in MOJ patients is tolerable and safe. STG has less influence on lipid metabolism than MCT/LCT does, and can increase albumin level rapidly. Key words: Pancreaticoduodenectomy; Structured triglyceride; Parenteral nutrition